Successful Craniotomy for Advanced Basal Cell Carcinomas with Cranial Bone Invasion and Dura Mater Infiltration - Unique Presentation in a Bulgarian Patient

  • Slavomir Kondoff Okrajna Bolnica - Neurosurgery Sofia, Sofia
  • Atanas Drenchev University Hospital Saint Anna - Neurosurgery Sofia, Sofia
  • Torello Lotti University G. Marconi of Rome, Institute of Dermatology, Rome
  • Uwe Wollina Städtisches Klinikum Dresden, Department of Dermatology and Allergology, Friedrichstrasse 41, Dresden
  • Ilia Lozev Medical Institute of Ministry of Interior, Department of General, Vascular and Abdominal Surgery, General Skobelev 79, 1606 Sofia
  • Ivan Pidakev Medical Institute of Ministry of Interior, Department of General, Vascular and Abdominal Surgery, General Skobelev 79, 1606 Sofia
  • Ivan Terziev University Hospital Tsaritsa Ioana, Department of Common and Clinical Pathology, Sofia
  • Yavor Grigorov Department of Orthopedics and Traumatology, University Hospital Lozenetz, Koziak 1 Street, Sofia
  • Serena Gianfaldoni University G. Marconi of Rome, Institute of Dermatology, Rome
  • Georgi Tchernev Medical Institute of Ministry of Interior (MVR), Department of Dermatology, Venereology and Dermatologic Surgery, General Skobelev Nr 79, Sofia; Onkoderma - Policlinic for Dermatology and Dermatologic Surgery, General Skobelev 26, Sofia
Keywords: Surgery, Craniotomy, Basal cell carcinomas, Treatment outcome, Treatment approach

Abstract

BACKGROUND: Basal cell carcinomas (BCC) located in the sun-exposed regions are a serious therapeutic challenge. Therefore early diagnosis and adequate therapy should be of a high priority for every dermatologic surgeon.

CASE PRESENTATION: We are presenting a patient with multiple BCCs, located on the area of the scalp, who had been treated several years ago with electrocautery and curettage after histopathological verification. However, the last few years the tumours have advanced, infiltrating firstly the tabula external and a year later the tabula interna of the cranium. A computed -tomography (CT) imaging and radiography of the skull were performed to reveal the definite tumour localisation, needed for planning an one - step surgical intervention. Both of the instrumental examinations confirmed the existence of osteolytic tumour lesions. Craniotomy with precise removal of the BCCs infiltrating the cranial bone in all of its thickness was performed. Partial resection of dura mater was also performed also because intraoperative findings established the involvement of the dura. Histopathological verification revealed bone and dural invasion with clean resection margins. The bone defect was recovered with hydroxyapatite cement. Reconstruction as the shape of the skull was carefully modified and adapted to its initial size and form. Layered closure of the skin and soft tissues were performed after the complete removal of the BCCs. The postoperative period had no serious complications.

CONCLUSION: Precisely managed therapy of BCC is curative in most of the cases as it ensures good prognosis for the patient.

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Published
2018-02-14
How to Cite
1.
Kondoff S, Drenchev A, Lotti T, Wollina U, Lozev I, Pidakev I, Terziev I, Grigorov Y, Gianfaldoni S, Tchernev G. Successful Craniotomy for Advanced Basal Cell Carcinomas with Cranial Bone Invasion and Dura Mater Infiltration - Unique Presentation in a Bulgarian Patient. Open Access Maced J Med Sci [Internet]. 2018Feb.14 [cited 2020Nov.25];6(2):372-5. Available from: https://www.id-press.eu/mjms/article/view/oamjms.2018.101
Section
C- Case Reports

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